The U.S. Food and Drug Administration (FDA) has issued a letter to bottled water manufacturers recommending that they limit the amount of fluoride added to bottled water so that it contains no more than 0.7mg/L. This recommendation was issued the same day the U.S. Department of Health and Human Services (HHS) released the final Public Health Service (PHS) recommendation for optimal fluoride level in drinking water. The new recommendation is for a single level of 0.7mg of fluoride per liter of water; this updates and replaces the previous recommended range of 0.7–1.2mg/L issued in 1962.

The PHS recommendation was developed after a panel of scientists and several federal agencies examined extensive literature on the relationship between fluoride intake and oral health. Since water fluoridation was first introduced in the U.S., several more sources of fluoride have become available including toothpaste and mouth rinses. The new recommended level will continue to to help prevent tooth decay and reduce the occurrence of dental fluorosis.

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While the PHS recommendation was issued for community water systems, the FDA recommendation is specific for bottled water. Fluoride can occur naturally in water sources used for bottled water or may be added by bottled water manufacturers. The FDA recommendation is specific to fluoride that is added to bottled water and does not affect the levels of fluoride permitted under the FDA’s bottled water regulations.

Almost 75% of Americans who are served by public water systems receive fluoridated water. The introduction of this practice, which the Centers for Disease Control and Prevention (CDC) named one of the 10 greatest public health achievements of the 20th century, has led to dramatic declines in both the prevalence and severity of tooth decay.

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